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原发性肝血管肉瘤自发破裂出血1例 预览

A case of spontaneous rupture of primary hepatic angiosarcoma
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摘要 原发性肝血管肉瘤(primary hepatic angiosarcoma,PHA)是临床上的一种罕见病,恶性程度高,由于发病率低、临床症状、体征及辅助检查缺乏特异性,容易误诊、漏诊,延误病情,影响患者的治疗效果和预后。2017年3月吉林大学第一医院收治了1例以“急性腹痛”为首发症状的肝血管肉瘤患者。此患者经CT检查误诊为肝血管瘤破裂出血,急诊行介入栓塞止血治疗。术后多次监测血常规,提示存在活动性出血,剖腹探查并切除肿瘤,病理证实为肝血管肉瘤。免疫组织化学示肿瘤细胞表达CD31和CD34。术后家属因经济受限等原因放弃治疗,出院后第2天死亡。 Primary hepatic angiosarcoma(PHA) is a rare disease with high malignancy. Due to the low incidence, atypical clinical symptoms and signs, it is oft en misdiagnosed, which results in missing timely treatment, and subsequently influencing the therapeutic effect and prognosis. A case of hepatic angiosarcoma with acute abdominal pain as the first symptom was reported in First Hospital affiliated to Jilin University in Match, 2017. Computed Tomography(CT) examination for this patient was misdiagnosed as a ruptured hemangioma of the liver, and emergency interventional embolization for hemostasis was performed. Blood routine was monitored several times aft er the operation, which indicated active bleeding. We performed laparotomy and excised the tumor, which was pathologically confirmed as hepatic angiosarcoma. Immunohistochemistry showed that tumor cells expressed CD31 and CD34. Aft er the operation, the family members gave up treatment due to economic limitations and other reasons, and the patient died on the second day aft er discharge.
作者 张强 霍建婷 王春艳 ZHANG Qiang;HUO Jianting;WANG Chunyan(Department of General Practice,First Affiliated Hospital of Jilin University,Changchun 130021,China)
出处 《中南大学学报:医学版》 CSCD 北大核心 2018年第11期1276-1280,共5页 Journal of Central South University (Medical Sciences) Journal of Central South University (Medical Sciences)
关键词 原发性肝血管肉瘤 肝肿瘤 误诊 primary hepatic angiosarcoma liver neoplasms misdiagnosis
作者简介 第一作者:张强,Email:504869430@qq.com,ORCID:0000-0003-3834-4688;通信作者:王春艳,Email:fengshe738@sohu.com,ORCID:0000-0002-8139-8692.
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